Abortion in Australia is legal, but women face high costs and access issues

Even though abortion is decriminalised across Australia and available under Medicare, women still face serious obstacles to obtain the surgical procedure.

Women are still being forced to spend $620 to obtain a surgical abortion in some states despite the fact it is decriminalised in Australia and available under Medicare.

As debate rages in the United States over Roe v Wade, health experts in Australia say even though abortion is decriminalised, there are still issues with access, cost and availability.

The cost of an abortion varies wildly from state to state and even within jurisdictions based on whether the procedure can be obtained through the public health system or a private clinic.

Abortion law is a state matter in Australia but it also involves federal laws through Medicare and the importation of RU486.

Now independents Monique Ryan, Zali Stegall and other crossbench MPs are considering asking the parliamentary library to research the cost, availability and legislative framework in each state for abortion with a view to considering future reform.

Cost of private surgical abortion starts at $620

In NSW, one of the largest providers is Marie Stopes, where the cost of an abortion in the first trimester starts at $620.

However, that’s only if you have a Medicare card. For those who do not have a card, for example asylum seekers on temporary protection visas, they could face upfront costs of over $800.

Children by Choice CEO Daile Kelleher said one of the biggest problems is it’s difficult for women outside of Queensland to find information or a one-stop-shop website.

“There isn’t anywhere with pricing as it’s so different,’’ she said.

“For example, in SA all terminations are done in public hospitals, Tasmania has public access and Queensland has public access.

“But there are still people who have barriers and have to pay private clinics. Marie Stopes is the largest provider across Australia.”

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One of the largest providers is Marie Stopes where the cost of an abortion in the first trimester starts at $620. Picture: Marie Stopes

Even the abortion pill is expensive

Medical abortions using the RU486 abortion pill can cost over $500 when ultrasounds and GP check ups are included.

RU486 is not the same as the morning after pill, which available over-the-counter in pharmacies at a cost of between $15 and $45.

The morning after pill may stop a pregnancy before it starts by preventing the release of an egg, whereas RU486 is a safe and effective way of terminating pregnancy up to nine weeks or 63 days.

If you’re under eight weeks pregnant you may be eligible for a tele-abortion over the phone, depending on where you live.

It’s a two-stage process involving a first pill to block the hormones for the pregnancy to continue and a second pill to expel the contents of the uterus.

Professor Deborah Bateson, a women’s reproductive health at the University of Sydney told news.com.au that there was still a long way to go despite recent improvements.

“Sometimes people get fee waivers. But, you know, that is challenging,’’ she said.

“Since decriminalisation, there have been some changes. Family Planning New South Wales, for instance, now provides medical and surgical abortion services. But that’s just one service in Sydney.

“There still are access challenges. There’s certainly good support from the College of Obstetricians and Gynaecologists to open up pathways into the public system.

“There are positive changes happening with the public or hospitals. But there’s still a long way to go.”

In NSW, Family Planning NSW offers limited surgical abortion services that are not as expensive as the major provider Marie Stopes.

It charges $352.24 for a surgical abortion but after the $187.25 Medicare rebate women are facing an out-of-pocket cost of $164.99.

Because it only offers limited service, many women end up at Marie Stopes to secure an appointment.

Abortion law is a state matter in Australia. Picture: Brook Mitchell/Getty Images.

Labor dumps pledge for free abortions

In 2019, Labor frontbencher Tanya Plibersek vowed to offer women taxpayer-funded abortions in public hospitals if elected.

But after the election there was concern in Labor ranks that the pledge had attracted anger from religious groups and some voters and as a result it was dumped.

“The Albanese government has not made any commitment similar to 2019. I’m trying to get a meeting with (Health Minister) Mark Butler to discuss and I’m hopeful given the weekend’s events he will meet with us,” Children By Choice’s Daile Kelleher said.

Health Minister Mark Butler told news.com.au the Albanese Government was committed to protecting and promoting the reproductive health and rights of all Australians.

“Equitable access to pregnancy termination services is a key measure of success in improving the sexual and reproductive health of women and girls as outlined in the National Women’s Health Strategy 2020-2030,’’ he said.

“While the laws relating to pregnancy termination are a state and territory responsibility, including the conditions for a termination to be performed, the Labor Government is committed to ensuring access to sexual and reproductive health care and addressing the underlying factors that limit genuine choice.”

The Government currently provides:

• Subsidies for a range of medicines for contraception and medical termination of pregnancy through the Pharmaceutical Benefits Scheme (PBS)

• Access to safe and legal termination and sterilisation procedures through the Medicare Benefits Schedule (MBS).

• Funding for the delivery of education to health professionals and individuals on family planning methods.

In 2019, Labor frontbencher Tanya Plibersek vowed to offer women taxpayer-funded abortions in public hospitals if elected. Picture: NCA NewsWire / John Gass

Queensland-based ‘Children by Choice’

The best information on abortion cost and availability is on the Queensland-based Children by Choice website but there’s nothing nationally that provides the same information by state.

In Queensland, abortions are provided by some hospitals, private day surgeries and GPs and the cost depends on whether you go public or private.

It also depends on whether you are using the abortion pill RU386 or a surgical abortion, where you live in the state and the gestation of the pregnancy.

Medication abortion - known as RU486 - is available to nine weeks gestation. At the time a woman misses a period she is 4 week pregnant.

That means the abortion pill is really only an option for the first five weeks after you find out you are pregnant.